This article describes a new operative technique to improve nasal airflow, the pyriform turbinoplasty. This specifically addresses the lateral part of the nasal valve where there may be impingement into the airway in select patients. This corresponds to the area over the “shoulder” of the inferior turbinate and directs airflow towards the middle meatus. A mucosal flap is raised and the frontal process of the maxilla and part of the lacrimal bone are resected, thereby improving the flow of air toward the middle meatus, without damaging mucosa. Clinical photographs of the technique are within the paper. The authors have reconstructed the nasal cavity using mapping software from CT scans of one patient and then built a model using ANSYS engineering simulation software. Using the principles of computational fluid dynamics, the velocity of air travelling through the nose has been simulated using fluid and known parameters have been included. This has then been repeated postoperatively. Simulated flows demonstrate that after surgery, there is a more uniform and improved airflow, although not necessarily faster. Ventilation in the main areas is improved without altering the pattern of airflow significantly. This is an interesting concept and one would hope due to the resection of bone, may provide long-term results. I’m sure these patients will be followed up and look forward to seeing the clinical results.
Pyriform turbinoplasty
Reviewed by Suki Ahluwalia
The effect of “Pyriform Turbinoplasty” on nasal airflow using a virtual model.
CONTRIBUTOR
Suki Ahluwalia
Cairns Hospital / James Cook University, Queensland, Australia.
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